Our federal government celebrated World No Tobacco Day by announcing that new health warnings, such as “Poison in every puff,” will soon be required on every cigarette. The regulations have been hailed by the usual authorities, described as a “world first”, or even as “a bold step” by the Minister of Mental Health and Addictions and Associate Minister of Health, Carolyn Bennett.
This policy will however be much less effective in reducing smoking than many others based on the understanding that smokers do not seek to voluntarily self-destruct, but rather have a terrible need for nicotine to satisfy their addiction, while hating the consequences of combustion on their health.
Today, nicotine consumption is not the same as combustion. The latter is responsible for most of the adverse health effects.
Combustion creates toxins and carcinogens. The consumption of nicotine in another form can significantly reduce the damage.
Sweden has the lowest lung cancer rate in Europe because smoking is very rare: Swedish people consume a lot of nicotine through moist snuff (a form of moist tobacco that is not smoked and usually placed under the upper lip) and “oral tobacco”. Japanese nicotine users are replacing cigarettes with heated tobacco products and the country is seeing a drop in cardiovascular disease hospitalizations. Smoking among young people is far from having disappeared in Canada, with the appearance of electronic cigarettes.
The smoking population in Canada is largely made up of low-income people, members of the LGBT+ community, people with schizophrenia, people with generalized anxiety disorder and ADHD, and the prison population. Nicotine is both a cognitive aid and a way to calm anxiety. Some of these groups have smoking rates above 50%.
Promote lower-risk products
In Canada, two obstacles prevent the adoption of a reduced harm option. One is ignorance, the other is over-reliance on all-or-nothing strategies.
Smokers should be aware that there is a range of lower risk nicotine products that will not have the same health consequences as burning. These products are marketed by giants in the pharmaceutical industry (nicotine patches, lozenges and gum), small independent producers (mainly electronic cigarettes) and the tobacco industry (electronic cigarettes, heated tobacco products and smokeless products). None of these products involve combustion.
Public Health England and the Royal College of Physicians say e-cigarettes are low in toxicity, and academic research validates that they are effective ways to quit smoking.
Recently, the British government announced that it would contact one million smokers to convince them to exchange their packs of cigarettes for a free vape.
On the other hand, in Canada those who welcome these warnings are fighting against the tobacco industry, while forgetting what psychologists tell us: positive reinforcement is the key to success. Smokers would benefit from a positive quit message on cigarette packs, rather than the over-the-top negativity currently required. The resulting stigmatization aggravates social exclusion.
Indeed, lower-risk products and high-risk products are sometimes produced by the same company. Angels are rare in the world of the nicotine industry. Cigarettes have killed countless people for a century, while Johnson & Johnson (maker of nicotine patches, lozenges and gum) recently paid out $20 billion to plaintiffs in fentanyl and talc claims in the United States. But if lower-risk products help smokers change their habits, their origin should not be an obstacle to their adoption.
For political comparison: alcohol steals countless years of life from society, yet there are no meaningful warnings on alcohol containers. And no warnings are printed on wine glasses, which would be the equivalent of warnings on cigarettes. For what ? Because the middle classes and the ruling elites don’t smoke much, but appreciate alcohol? I do not advocate the affixing of warnings on our bottles of Pinot Grigio, like those found on cigarette packets. Moderate alcohol consumption probably has the same impact on our longevity as the use of smokeless nicotine products.
Canada urgently needs to get middle-aged and older smokers to quit. They are so addicted to nicotine that a “quit or die” approach will prove useless in most cases. Instead of making life even harder than it already is for these groups by torturing them, why not take to the streets and educate smokers to use safer products that don’t involve combustion?
Finally, Ottawa should consider the success of the illegal nicotine market in Canada. At least a quarter of all cigarettes consumed come from it. Policies to further ostracize smokers will strengthen this market.
* The author has worked for the Government of Canada on alcohol and tobacco policy, as well as in the private (legal) sector. Some of his research is funded by the Foundation for a Smoke-Free World.